Is Henoch –Schönlein purpura a susceptibility factor for functional gastrointestinal disorders in children?AbstractHenoch –Schönlein purpura (HSP), the most common childhood vasculitis is characterized by non-thrombocytopenic palpable purpura, arthritis/arthralgia, abdominal pain and renal involvement. Functional gastrointestinal disorders (FGIDs) are heterogeneous disease spectrum with unclear etiology and include the most common subtypes: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain and functional constipation. Formerly, FGIDs were known as non-organic disorders; however, recent advances revealed that low-grade inflammation may also play a role. We aimed to clarify whether HSP pre...Source: Rheumatology International - August 12, 2018 Category: Rheumatology Source Type: research

Ultrasound of sacroiliac joints in spondyloarthritis: a systematic reviewAbstractUltrasound (US) is an accessible imaging technique with a possible role to diagnose active sacroiliitis, so this technique is projected as a promising diagnostic tool for the diagnosis of SpA. We analyse the available evidence about the use of US as a diagnostic tool in sacroiliitis in patients with SpA, by a systemic review of the literature fulfilling OMERACT criteria. A systematic literature search for original articles was carried out using four databases (Medline, Embase, Scopus and Web of Science). Data from studies were included only if participants had SpA and a US examination of sacroiliac joint (SIJ) was ...Source: Rheumatology International - August 11, 2018 Category: Rheumatology Source Type: research

A retrospective study comparing the phenotype and outcomes of patients with polyarteritis nodosa between UK and Turkish cohortsThis study is aimed to study the demographic and clinical features of PAN cohorts from the UK and Turkey (TR) and to compare and contrast disease characteristics. A retrospective survey of databases from two vasculitis centres between 1990 and 2016 for PAN patients fulfilling the EMEA Vasculitis Classification algorithm. All paediatric-onset adult patients met the Ankara 2008 (EULAR/PReS endorsed) criteria for childhood PAN. Those with typical angiographic and/or histopathologic findings consistent with PAN were included. 93 (M/F: 51/42) patients (UK: 47, TR: 46) were included. Three were HBV-related, 20 (21.5%) had paedia...Source: Rheumatology International - August 11, 2018 Category: Rheumatology Source Type: research

Ankylosing spondylitis causes high burden to patients and the healthcare system: results from a German claims database analysisAbstractTo compare healthcare resource utilization and costs between ankylosing spondylitis (AS) patients and a matched sample from the general population without AS covered by the German Statutory Health Insurance (SHI) system, a non-interventional retrospectively matched cohort analysis was conducted using anonymized SHI claims data. Data from January 1st, 2011 through December 31st, 2014 were analyzed. Individuals with a coded diagnosis of AS during the enrollment period comprising the full year of 2013 were directly matched (1:5) to individuals without AS diagnosis in the whole study period by age, gender, hospitalizat...Source: Rheumatology International - August 9, 2018 Category: Rheumatology Source Type: research

M2 macrophages and their role in rheumatic diseasesAbstractAs a component of the innate immune system, macrophages play a crucial role in host defense against a variety of microbes. Conventionally, macrophages have been classified as M1 and M2 depending on their phenotype and role in immune regulation. M1 macrophages are generally pro-inflammatory, while M2 (also known as alternatively activated macrophages) are anti-inflammatory. M1 macrophages release pro-inflammatory cytokines, reactive nitrogen, and oxygen intermediates, and kill pathogens, whereas their M2 counterparts participate in the resolution of inflammation, remodeling of tissue, angiogenesis, and tissue repair...Source: Rheumatology International - August 9, 2018 Category: Rheumatology Source Type: research

Is age associated with disease severity and compliance to treatment in children with familial Mediterranean fever?In this study, we aimed to compare disease characteristics and treatment compliance according to the age of pediatric FMF patients. This is a single-center, cross-sectional study. Between August and October 2016, patients who were diagnosed with FMF, participated to the study. 378 pediatric FMF patients were enrolled in the study. Among those, age at symptom onset was ≤ 5 years in 69%, 6–11 years in 26% and ≥ 12 years in 5%. Patients older than 12 years old at symptom onset, had significantly less frequent fever attacks than the patients from other age groups. Patients younger ...Source: Rheumatology International - August 7, 2018 Category: Rheumatology Source Type: research

Observational study and brief analysis of diagnostic criteria in relapsing polychondritisAbstractObservational study of patients with relapsing polychondritis (RPC) and brief evaluation of widely used diagnostic criteria. A retrospective analysis of 18 patients with RPC treated in the past 15 years at the Charté—Universitätsmedizin Berlin was performed. Three different diagnostic criteria were applied to our cohort. Sensitivities of diagnostic criteria of McAdam et al., Damiani and Levine and Michet et al. were calculated as well as the 5- and 10-year survival. Analysis of diagnost ic criteria revealed a sensitivity of 88.9% using Damiani and Levine criteria, 66.7% for Michet et al. and...Source: Rheumatology International - August 6, 2018 Category: Rheumatology Source Type: research

Reduced anterior cingulate grey matter volume in painful hand osteoarthritisConclusionOur study found evidence of reduced ACC grey matter volume in participants with hand arthritis that persisted after treatment with centrally acting analgesics pregabalin and duloxetine, respectively. The sustained changes observed in the ACC in our study could reflect the relatively short duration of treatment, or that the differences observed are irreversible volume changes due to chronic pain that are established over time. (Source: Rheumatology International)Source: Rheumatology International - July 13, 2018 Category: Rheumatology Source Type: research

Smoking, disease characteristics and serum cytokine levels in patients with primary Sj ögren’s syndromeIn this study, a negative association between ever smoking and positive lip biopsy was found, confirming previous reports. Expected differences in cytokine levels compare d to controls were noted, but no major differences were found between ever and never smoking pSS patients. Taking into account the negative association between pSS diagnosis and smoking in epidemiological studies, possible explanations include a local effect of smoking on salivary glands rather than systemic effects by cigarette smoke. (Source: Rheumatology International)Source: Rheumatology International - July 13, 2018 Category: Rheumatology Source Type: research

Rheumatoid factor isotype and Ro epitope distribution in primary Sj ögren syndrome and rheumatoid arthritis with keratoconjunctivitis siccaAbstractPrimary Sj ögren syndrome (pS) is associated with autoantibodies such as rheumatoid factor (RF) and anti-nuclear antibodies such as anti-Ro (SS-A) and/or La (SS-B). Recent developments within autoimmune diagnostics allow quantitation of RF subclasses and anti-Ro epitopes. Will this refinement by autoimmune di agnostics help predicting development of extraglandular manifestations (EGM) in pS patients? A cohort of pS and rheumatoid arthritis (RA) patients with keratoconjunctivitis sicca (n = 35 and 16, resp) was included. Of the pS patients, 54% developed one or more EGM. Antibodies quantitated wer...Source: Rheumatology International - July 13, 2018 Category: Rheumatology Source Type: research

Higher levels of serum interleukin-35 are associated with the severity of pulmonary fibrosis and Th2 responses in patients with systemic sclerosisAbstractThe aim of the study is to investigate the levels of serum interleukin-35 (IL-35) before and after treatment and its relationship with clinical parameters as well as the frequency of different subsets of CD4+ T cells in patients with systemic sclerosis (SSc) to explore the role of IL-35 in the pathogenesis of SSc. The levels of serum IL-35, interferon- γ (IFN-γ), IL-4, IL-17A, and IL-10 in 49 patients with SSc and 50 age- and gender-matched healthy subjects were measured by enzyme-linked immunosorbent assay (ELISA). The percentages of peripheral blood Th1, Th2, Th17 cells and Tregs in 49 SSc patients an...Source: Rheumatology International - July 13, 2018 Category: Rheumatology Source Type: research

Comparative short-term effectiveness of ibuprofen gel and cream phonophoresis in patients with knee osteoarthritisThe objective of the present study was to compare the effectiveness of gel and cream ibuprofen phonophoresis in patients with knee osteoarthritis. A single-blinded, randomized, comparative design was applied. Patients diagnosed with knee osteoarthritis according to the American College of Rheumatology criteria were included in the study. After obtaining written informed consent, patients were randomized into ibuprofen gel and cream phonophoresis groups. Each patient was treated five sessions per week for 2 weeks (ten sessions). Main outcome measures were 100 mm visual analogue scale (VAS) for pain and the diseas...Source: Rheumatology International - July 12, 2018 Category: Rheumatology Source Type: research

Real-world incidence and prevalence of systemic lupus erythematosus in Alberta, CanadaAbstractSystemic lupus erythematosus (SLE) is rather uncommon than rare. The purpose of this study was to estimate the incidence and prevalence of SLE in the population of Alberta, Canada, using administrative health data. Multiple population-based data sources, including the Alberta Health Care Insurance Plan Central Stakeholder Registry (AHCIP CSR), Fee-For-Service, and Hospital Discharge Abstract Database were used. Age- and sex-specific incidence and prevalence rates, and 95% confidence intervals (CI), were computed using the AHCIP CSR mid-year population estimates as the denominator, for the period of 2000 –2015...Source: Rheumatology International - July 9, 2018 Category: Rheumatology Source Type: research

Non-obese visceral adiposity is associated with the risk of atherosclerosis in Japanese patients with rheumatoid arthritis: a cross-sectional studyThe objective of the study was to determine the association between obesity and/or visceral adiposity and the risk for atherosclerosis in Japanese RA patients. Obesity was evaluated using the BMI, with visceral adiposity evaluated using the visceral fat area (VFA) and the visceral/subcuta neous fat ratio (V/S ratio), quantified using the dual bioelectrical impedance method. Atherosclerosis was evaluated based on the intima–media thickness (IMT) and Plaque score (PS) of the carotid artery, measured using ultrasonography. Multivariate analysis was performed to determine the factors a ssociated with IMT and PS. IMT and ...Source: Rheumatology International - July 4, 2018 Category: Rheumatology Source Type: research

Cardiovascular system changes in rheumatoid arthritis patients with continued low disease activityThe objective of the study was to assess chosen CV parameters in RA patients who have continuous low disease activity. The study group consisted of 70 RA patients without known CVD and 33 healthy controls, of a comparable age. All RA patients had continued low disease activity (DAS28 ≤ 3.2) from 2 to 7 years. The groups were assessed for: blood pressure, serum amino-terminal pro-brain natriuretic peptide (NT-proBNP), carotid intima media thickness (cIMT), electrocardiography (ECG), ejection fraction (EJ) and diastolic dysfunction (E/A ratio) in echocardiography. In RA patients in comparison with cont...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

The impact of anti-U1-RNP positivity: systemic lupus erythematosus versus mixed connective tissue diseaseAbstractAnti-U1-RNP positivity remains mandatory for the mixed connective tissue disease (MCTD) diagnosis, reason for which anti-U1-RNP occurrence in patients with lupus clinical features might determine diagnostic issues. Thus, the prevalence of 25 –30% for anti-RNP was reported in John Hopkins and LUMINA lupus cohorts and also 13% prevalence for the anti-U1-RNP in Euro-Lupus cohort. Presence of anti-U1-RNP antibodies in patients fulfilling SLE criteria (but not the MCTD ones) was associated with manifestations such as Raynaud phenomenon, mu sculoskeletal and lung impairment or nail fold capillaroscopy changes, some...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

Juvenile idiopathic arthritis in the biologic era: predictors of the disease progression and need for early introduction of biologic treatmentAbstractTo assess longitudinally the course and outcome of juvenile idiopathic arthritis (JIA) in patients diagnosed and followed-up exclusively in the biologic era; also, to define possible predictors of the disease progression and need for early implementation of biologicals. Prospective and retrospective, monocentric cohort study of 120 JIA patients, diagnosed between 2001 and 2010, and followed-up for ≥ 4 years (median 8.04). Disease activity, cumulative articular/extra-articular damage and quality of life were evaluated by the assessment tools Juvenile Arthritis Disease Activity Score (JADAS71), Juvenil...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

Improvement of neurological and ocular symptoms of Beh çet’s disease after the introduction of infliximabWe present a 43-year-old female patient with the history of recurrent episodes of genital and oral ulcerations, elevated acute phase reactants and skin lesions. The diagnosis of Behçet’s disease has been delayed (for more than 10 years) and reached only after she developed neurological and ocular symptoms. Treatment with glucocorticoids and azathioprine was partially successful. High doses of glucocorticoids were needed to control the disease and cyclosporine A was nephrotoxic. Remission was reached after the introduction of infliximab (plus metho trexate) and glucocorticoids were stopped. In the rec...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

Kawasaki disease in Spanish paediatric population and synoptic weather types: an observational studyIn this study we analyse the temporal pattern and geographical distribution of the disease in Spain, and its relationship with atmospheric circulation patterns. We performed a retrospective study in which we collected all hospital admissions due to KD in the country between 2005 and 2015 and explored their relationship with demographic and geographical characteristics. Moreover, we calculated daily surface atmospheric patterns over Spain to study the relationship between weather types (WT) and KD Admissions. The average admission rate for KD in the paediatric population was 3.90 per 100,000, with a male to female ratio of ...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

Correlates and predictors of paediatric leg pain: a case –control studyAbstractPaediatric leg pains, long described as ‘growing pains’, frequently present to clinicians, are prevalent in early childhood, disrupt sleep, and distress affected children and parents. There are many cited associations, but no defined leg pain sub-types, nor revealed predictive factors. We explored the implicated factors (viz. foot arc hes, foot strength, joint mobility, vitamin D, iron) in children with leg pain versus a control group. Leg pain sub-groups—growing pains (GP), restless legs (RLS), both (mixed)—are defined for the first time. A case controlled study design, in a primary care se...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

Patients with systemic rheumatic diseases admitted to the intensive care unit: what the rheumatologist needs to knowAbstractPatients with systemic rheumatic diseases (SRDs) may require admission to the intensive care unit (ICU) throughout the course of their disease. Therefore, the rheumatologist needs an understanding of the factors which may influence the course of patients with SRDs who are admitted to ICU. These include the causes for admission, patient characteristics including comorbidities and drug therapies, outcome (in-ICU mortality and causes of death), and prognostic factors. Infections and exacerbation/complications of SRDs are the most common (and potentially reversible) reasons for both admission and death on ICU. Mortalit...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

The EJES-3D tool for personalized prescription of exercise in axial spondyloarthritis through multimedia animations: pilot studyAbstractTo develop and evaluate a web application based on multimedia animations, combined with a training program, to improve the prescription of exercises in spondyloarthritis (SpA). After a review of exercises included in the main clinical trials and recommendations of international societies, a multidisciplinary team —rehabilitators, rheumatologists, physiotherapists, computer scientists and graphic designers—developed a web application for the prescription of exercises (EJES-3D). Once completed, this was presented to 12 pairs of rehabilitators–rheumatologists from the same hospital in a workshop. Kno...Source: Rheumatology International - June 18, 2018 Category: Rheumatology Source Type: research

Recognition and control of hypertension, diabetes, and dyslipidemia in patients with rheumatoid arthritisAbstractAbsolute cardiovascular risk of an individual with rheumatoid arthritis (RA) is greater when compared to the general population, and several factors have proven to be important for the development of coronary artery disease (CAD) in these patients, including factors related to the underlying disease, such as the systemic inflammatory response, drugs used in its treatment, and a higher prevalence of traditional risk factors for CAD. Our aim is to describe the recognition and control frequencies of systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM) in RA patients. Patients with RA answered...Source: Rheumatology International - June 15, 2018 Category: Rheumatology Source Type: research

Lupus retinopathy: a marker of active systemic lupus erythematosusAbstractRetinopathy in the context of systemic lupus erythematosus (SLE) is associated with severe disease and poorer prognosis. We studied retinopathy in our cohort of Indian lupus patients. Four hundred and thirty-seven patients fulfilling the Systemic Lupus International Collaborating Clinics-American College of Rheumatology-2012 criteria, attending the department of Clinical Immunology were enrolled under this cross-sectional study. A comprehensive clinical (including ophthalmological) examination and immunological profile were performed. Retinopathy was defined if cotton-wool spots, haemorrhages, vasculitis, retinal d...Source: Rheumatology International - June 13, 2018 Category: Rheumatology Source Type: research

Leptin as an obesity marker in rheumatoid arthritisAbstractThe determination of excess of body fat mass provides a more suitable determinant of obesity in rheumatoid arthritis patients; however, body mass index (BMI) may not be accurate for the quantification of adiposity. To identify a marker of excess adiposity in women with rheumatoid arthritis (RA) using different methods for fat mass evaluation. A cross-sectional study was conducted in adult female patients with RA. Disease activity was assessed by DAS28-ESR, and obesity was determined by waist circumference (WC), BMI and dual-energy X-ray absorptiometry (DXA). The Human Bone Metabolism kit (Merck Millipore, Darmstadt...Source: Rheumatology International - June 11, 2018 Category: Rheumatology Source Type: research

Cross-cultural adaptation and validation of the Saudi Arabic version of the Knee Injury and Osteoarthritis Outcome Score (KOOS)This study aimed to culturally adapt and evaluate the psychometric properties of the Saudi Arabic version of the KOOS in patients with knee OA. The original KOOS was translated and adapted into Saudi Arabic version over six stages according to the guidelines suggested by Beaton and recommended by the American Association of Orthopedic Surgeons Outcome Committee. Patients diagnosed with knee OA (n = 136) were recruited to examine the psychometric properties, such as internal consistency that was tested using Cronbach’s alpha, test–retest reliability that was analyzed using the intra-class correlati...Source: Rheumatology International - June 7, 2018 Category: Rheumatology Source Type: research

The emerging role of cardiovascular magnetic resonance imaging in the assessment of cardiac involvement in juvenile idiopathic arthritisAbstractJuvenile idiopathic arthritis (JIA) is the commonest rheumatic disease in childhood and presents several subtypes according to the ILAR classification. JIA, specifically in its systemic form, may seriously damage various structures of the cardiovascular system. Other JIA phenotypes are also of interest, as cardiovascular disease (CVD) is underestimated and understudied, but chronic systemic inflammation and risk factors remained important contributors for CVD development. The currently applied non-invasive modalities, although they are important for the initial evaluation of JIA patients, frequently fail to detect ...Source: Rheumatology International - June 6, 2018 Category: Rheumatology Source Type: research

A new biopsychosocial and clinical questionnaire to assess juvenile idiopathic arthritis: JAB-QConclusionJAB-Q is a valid and reliable multidimensional biopsychosocial outcome tool that can be used routinely in clinical practice of pediatric rheumatology. The main advantage of this tool is incorporation of patients ’ and parents’ perspectives separately while providing a practical and standard setting for the clinician’s evaluation. However, further validation of this tool in an independent cohort is needed to improve its applicability. (Source: Rheumatology International)Source: Rheumatology International - June 5, 2018 Category: Rheumatology Source Type: research

Novel insights into the role of inflammasomes in autoimmune and metabolic rheumatic diseasesAbstractInflammasomes are large intracellular complexes that induce inflammation in response to exogenous and endogenous damage signals. They regulate production and release of the proinflammatory cytokines IL-1 β and IL-18, playing a defensive role against infections. Inflammasomes have also been involved in the pathogenesis of a wide range of autoinflammatory conditions that are caused by dysregulation of the IL-1 pathway, such as cryopyrinopathies and hereditary periodic fever syndromes. On top of that, research in recent years suggests that defects in inflammasome regulation and signaling associate with a number o...Source: Rheumatology International - June 4, 2018 Category: Rheumatology Source Type: research

Decreased CD22 expression and intracellular signaling aberrations in B cells of patients with systemic sclerosisThe objective of the study was to explore the phenotype and intracellular signaling events of B cells in patients with systemic sclerosis (SSc). Peripheral blood B cell surface markers CD19 and CD22 were evaluated by flow cytometry in 23 patients with SSc and seven healthy individuals. Levels of intracellular kinases Lyn, Syk and P-Y 348 Syk along with phosphatase SHP-1 were examined with Western immunoblotting in selected patients. P-Y 822 CD22 was subsequently evaluated flow cytometrically in antigen receptor stimulated B cells. A statistically significant decrease in CD22 B cell surface expression was found in the...Source: Rheumatology International - June 4, 2018 Category: Rheumatology Source Type: research

The role of mirtazapine in patients with fibromyalgia: a systematic reviewThe objective of this systematic review is to assess the efficacy and safety of mirtazapine in the treatment of patients with fibromyalgia. Pubmed (1946-May 2018), Embase (1947-May 2018), CENTRAL, and ClinicalTrials.gov were queried using the search term combination: fibromyalgia, pain, chronic pain, neuralgia, neuropathic pain, chronic widespread pain, or chronic pain syndrome and mirtazapine. Studies appropriate to the objective were evaluated, including three randomized, placebo-controlled trials and one open-label trial, investigating the effect of mirtazapine in patients with fibromyalgia. In patients with fibromyalgi...Source: Rheumatology International - June 2, 2018 Category: Rheumatology Source Type: research